Hair transplant with finasteride

[Enoch]

I am 35 years old and losing my hair around the crown area and my hair line is receding. Having a high hairline doesn't bother me but losing hair on the crown does. 

I generally have bad side effects with most drugs and i don't like the idea of taking a pill for the rest of my life. 

If I am not getting my hairline extended forwards is it sensible to have a hair transplant, just to fill in what I already have, without taking finasteride?

Any help would be greatly appreciated 

[gillenator]

Please provide some pics so we will be able to offer some feedback for you.

[MAIZE1694]

56 minutes ago, Enoch said:

I am 35 years old and losing my hair around the crown area and my hair line is receding. Having a high hairline doesn't bother me but losing hair on the crown does. 

I generally have bad side effects with most drugs and i don't like the idea of taking a pill for the rest of my life. 

If I am not getting my hairline extended forwards is it sensible to have a hair transplant, just to fill in what I already have, without taking finasteride?

Any help would be greatly appreciated 

You can always discontinue fin if you get sides.

Best case scenario you regrow some hair and slow MPD to a crawl/eliminate it.

Worse case scenario you get sides and stop using it.

[Enoch]

Here are some images of my hair atm. There is a big difference between how my hair looks dry and wet. It looks like there is more than there is when it is dry haha.

[Melvin- Admin]

The crown is not gone enough to get an HT in my opinion. You risk more than you gain. I would stick with finasteride, perhaps include some other treatments like minoxidil, laser therapy, dermaroller, etc. You can also use hair fibers, which work wonders in the crown. 

 

[Enoch]

That's interesting Melvin. What do you mean by "I risk more than the gain"? I have tried to read around the topic but it is a lot of info. 

Back to the original question; if I got a HT in a couple of years to fill in the top of my head and didn't use fin, would there be a big risk that my hair would look very stupid in 10 or 15 years?

 

Thanks for all the responses and help guys!

Edited April 23, 2022 by Enoch
Forgot to say thank you

[Eugenix Hair Sciences]

10 hours ago, Enoch said:

Here are some images of my hair atm. There is a big difference between how my hair looks dry and wet. It looks like there is more than there is when it is dry haha.

You do not require a hair transplant on the crown area at all for now. You require finasteride more than anything else to improve that area. But as you are not okay taking medications, you will lose more hair in the coming future. Hence, you will require a hair transplant in the crown. Over time you will lose more hair requiring another transplant in the newly empty areas.

[graft81]

18 hours ago, MAIZE1694 said:

You can always discontinue fin if you get sides.

Best case scenario you regrow some hair and slow MPD to a crawl/eliminate it.

Worse case scenario you get sides and stop using it.

There may also be persistent side effects after you stop taking it.

Edited April 23, 2022 by graft81

[Mike10]

22 hours ago, MAIZE1694 said:

You can always discontinue fin if you get sides.

Best case scenario you regrow some hair and slow MPD to a crawl/eliminate it.

Worse case scenario you get sides and stop using it.

Actually PFS or semi-permanent sides are worst case scenario

[gillenator]

IMHO, the apparent risk would be shock loss to your crown because your pics show that you have a diffused thinning pattern…minoxidil can potentially thicken that area up or the use of cosmetic hair fibers.

[blufforfold]

5 hours ago, gillenator said:

IMHO, the apparent risk would be shock loss to your crown because your pics show that you have a diffused thinning pattern…minoxidil can potentially thicken that area up or the use of cosmetic hair fibers.

Question about shockloss. We see a lot of people with minimal hair loss (I even have been warned about shockloss though I have more hairloss than OP) but when it comes to people getting their 2nd,3rd,4th surgeries we rarely see anybody comment about shockloss, why is that? You see people thickening up their hairline, and we certainly see lots of crown surgeries on surgery 2/3/4 when the person is already pretty full sometimes they are just doing that list fill if 500-700 grafts in the crown. Why are those people never told that they are risking shock-loss but then people in OPs position are always told that they are risking shockloss. Im a newbie so I dont understand the double standard, is there an actual reason for this? IMO this happens even in cases when somebody has no prior surgery in the crown and never had that bad of crown to beginwith, so lets say a NW3 or even a NW4 who happens to have a not overly bad crown, comes in for his 2nd or 3rd surgery for the crown with tons of native hair and nobody ever talks about shockloss that ive seen in those threads doing my research lately

[Gatsby]

You should try minoxidil in the crown if you can’t take Finasteride. All the best. 

[Curious25]

11 hours ago, blufforfold said:

Question about shockloss. We see a lot of people with minimal hair loss (I even have been warned about shockloss though I have more hairloss than OP) but when it comes to people getting their 2nd,3rd,4th surgeries we rarely see anybody comment about shockloss, why is that? You see people thickening up their hairline, and we certainly see lots of crown surgeries on surgery 2/3/4 when the person is already pretty full sometimes they are just doing that list fill if 500-700 grafts in the crown. Why are those people never told that they are risking shock-loss but then people in OPs position are always told that they are risking shockloss. Im a newbie so I dont understand the double standard, is there an actual reason for this? IMO this happens even in cases when somebody has no prior surgery in the crown and never had that bad of crown to beginwith, so lets say a NW3 or even a NW4 who happens to have a not overly bad crown, comes in for his 2nd or 3rd surgery for the crown with tons of native hair and nobody ever talks about shockloss that ive seen in those threads doing my research lately

Im assuming it will be because patients on their 3rd and 4th transplants likely have a higher ratio, if not total, scalp full of previously transplanted hair - which is theoretically as stable as you can get, given it has been harvested from permanently non DHT affected zones.  
 

Whilst shock loss can occur on any type of hair follicle, the only real cause for concern is permanent shock loss - which is only ever truly associated with hair that is miniaturised, a state in which previously transplanted hair shouldn’t ever reach. 
 

Surgeon error, and damage to surrounding follicles could also cause permanent shock loss to even the healthiest of hairs (whether this is in your donor during extractions or recipient during implantations) however under a top surgeons hands, this shouldn’t be much of a concern or consideration. 

[Enoch]

Really helpful discussion. Thanks for the responses. I am reluctant to take fin, but it seems like that is the overwhelming recommendation for someone in my position. So I am considering taking fin now.

What are the possible risks of taking fin and how safe is it?

[gillenator]

20 hours ago, Gatsby said:

You should try minoxidil in the crown if you can’t take Finasteride. All the best. 

I agree…minoxidil can improve hair caliber and also prolong the anagen phase in the growth cycle.

[SeanT1]

If you're insecure about your crown you can always do some SMP on it for density.

You should do this before your hair transplant as you'll be unable to preform smp for the first 6 months after a ht.

Edited April 24, 2022 by SeanToman

[blufforfold]

On 4/24/2022 at 2:14 AM, Curious25 said:

Im assuming it will be because patients on their 3rd and 4th transplants likely have a higher ratio, if not total, scalp full of previously transplanted hair - which is theoretically as stable as you can get, given it has been harvested from permanently non DHT affected zones.  
 

Whilst shock loss can occur on any type of hair follicle, the only real cause for concern is permanent shock loss - which is only ever truly associated with hair that is miniaturised, a state in which previously transplanted hair shouldn’t ever reach. 
 

Surgeon error, and damage to surrounding follicles could also cause permanent shock loss to even the healthiest of hairs (whether this is in your donor during extractions or recipient during implantations) however under a top surgeons hands, this shouldn’t be much of a concern or consideration. 

Ah I see, but I do feel like quite a lot of the times when its on the crown, those people dont have any prior surgeries on the crown so the area of native hair actually is their natural native hair. I do get your distinction but in a lot of the examples when someone is losing lets say 80% front and 20% crown and they just leave their crown untouched until later surgeries, those crown areas dont have transplanted hairs so should theoretically be susceptible all the same.

In that case would you feel I should be worried about perm shock loss in my situation if I want to do a crown surgery?

 

[Enoch]

Based on everyone's recommendation, I have started taking finasteride. It is early days ( day 2 to be precise 🤣). I am starting off with the standard dose, get my hairloss a bit more under control and then try microdosing, initially at 0.5mg and then 0.25mg. I was wondering since the tablets only come in 1mg, how do people microdose? Do they cut them in half or do they do every other day?